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Social Security Disability Insurance, or SSDI, is a federal program that provides financial assistance to people with disabilities. Along with Supplemental Security Income, or SSI, it is one of two disability benefits programs offered by the Social Security Administration (SSA).
To qualify for SSDI, you must meet certain requirements. If eligible, you could be entitled to certain SSDI benefits, which are intended to assist with medical expenses and the general cost of living.
Filing a Social Security Disability Insurance claim can be challenging, and many first-time applicants are denied benefits. At Affleck & Gordon, we have extensive experience helping people navigate this system and recover the benefits they are owed under the law. If you have questions about your claim, need help with your application, or wish to appeal a denied SSDI claim, do not hesitate to contact our SSDI attorneys right away.
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Individuals who qualify for Social Security Disability Insurance (SSDI) are entitled to monetary benefits. These benefits are paid on a monthly basis. Benefits are calculated not on the severity of an individual’s disability but, rather, on the individual’s “average indexed monthly earnings,” or AIME.
An individual’s AIME refers to the average amount the individual earned in taxable income over a certain period of time. This amount is then plugged into a formula, which is adjusted annually, to find the individual’s “primary insurance amount,” or PIA. The PIA serves as the basic amount used to determine the individual’s SSDI benefits.
Recently, the Social Security Administration (SSA) announced an unprecedented cost-of-living adjustment (COLA) of 5.9% in both SSDI and SSI benefits for 2022 as a result of high inflation. For SSDI, increased benefits began in January 2022, and SSI benefit increases began in December 2021.
Who Is Eligible for SSDI?
To qualify for Social Security Disability Insurance (SSDI), you must meet the following criteria:
- You have a medical condition that qualifies as a disability according to the Social Security Administration’s definition of “disability”
- Your qualifying medical condition has prevented you from working or engaging in any type of “substantial gainful activity” (SGA) for at least one year
- You have worked long enough and recently enough, and you have paid Social Security taxes on your income/earnings
By working long enough and recently enough in a job covered by Social Security, you earn “work credits.” Work credits can be earned through both annual wages and self-employment income and are capped at four work credits per year. The amount of income needed to earn work credits changes each year. In 2022, you can earn one work credit for every $1,510 in taxable wages or income you receive.
To qualify for SSDI, you must earn the appropriate number of work credits. In most cases, you must have at least 40 work credits, and you must have earned at least half of those (20) in the 10 years immediately preceding your disability. However, the exact number of work credits you will need to qualify for SSDI benefits will depend on how old you are when you become disabled.
The SSA has a strict definition of “disability.” To qualify for SSDI benefits, your medical condition must meet this definition. You cannot receive SSDI benefits if you are partially disabled or if you have a short-term disability that lasts for less than a year.
According to the SSA, a medical condition qualifies as a “disability” if it:
- Prevents the individual from performing the work they did before they became disabled or adjusting to modified work or another form of work
- Prevents an individual from engaging in any type of substantial gainful activity (SGA)
- Lasts or is expected to last for at least one year and/or result in death
If your medical condition does not meet all of these criteria, you may not qualify for SSDI benefits.
The SSDI Process
There are several steps involved in the SSDI process. It is important that you correctly follow these steps, as any mistake on your application could result in your claim being denied.
Below is a general overview of how to apply for SSDI:
- First, you must gather the appropriate documents and supplementary information, such as information about your work history, your medical condition, proof of citizenship, and more
- Next, you should fill out and submit an SSDI application online, by phone, by mail, or in person at your local Social Security Administration (SSA) office
- Then, the SSA will review your application and process it before sending it to the Georgia Disability Determination Services office (or the office in your state)
- The Disability Determination Services office will decide on your case and either award benefits or deny your claim
Our SSDI attorneys at Affleck & Gordon can assist you in applying for disability benefits. We are very familiar with the process and can help ensure your application is properly filled out with all supporting documents and information provided.
How long do I have to appeal a denied SSDI claim?In nearly all cases, you have just 60 days to request a reconsideration, administrative hearing, Appeals Council review, or federal court review. The 60-day deadline typically begins on the date on which you received the official notice that your SSDI claim was denied.
What type of medical conditions are considered "disabilities?"
The Social Security Administration has a very strict definition of “disability.” Your medical condition must meet the SSA’s definition of disability for you to qualify for SSDI benefits.
The SSA has a list of medical conditions, known as the “list of impairments,” that it generally considers being disabilities. Some of these conditions include various types of musculoskeletal disorders, cardiovascular disease, cancer, digestive disorders, skin conditions, mental illnesses, immune system disorders, and more. If your medical condition is not listed, you may still qualify for SSDI benefits if the SSA decides that it is a “qualifying disability.” To have a non-listed qualifying disability, your medical condition must be at least as severe as one of the medical conditions listed in the SSA’s list of impairments.
How are SSDI payments calculated?
The Social Security Administration uses a complicated formula to calculate SSDI benefits. First, it takes an individual’s average income from the 35 years in which they earned their highest income. This number is the “average indexed monthly earnings,” or AIME. The SSA then plugs the AIME into a formula to determine different percentages, or “bend points,” which are used to determine the individual’s “primary insurance amount,” or PIA. The bend points change each year. In 2022, they are 90% of the first $1,024 of an individual’s AIME; plus 32% of the amount in AIME between $1,024 and $6,172; and 15% of the amount in AIME over $6,172.
What is the maximum SSDI benefit I can receive?
Your lifetime earnings determine the exact amount you can receive in SSDI benefits. However, the Social Security Administration also sets a maximum monthly benefit amount, which applies to all SSDI recipients. In 2022, the maximum SSDI benefit is $3,345 per month.
What is the average amount you can receive in SSDI benefits?
Various unique factors—including lifetime earnings—play a role in someone’s actual SSDI benefit amount. That being said, the average disability benefit for 2022 is $1,358 per month.
Can I receive social security disability insurance benefits if I'm working?
You may not receive SSDI benefits if you are engaged in “substantial gainful activity” (SGA). The Social Security Administration defines SGA by certain income thresholds, which change annually. For 2022, SGA is set at $1,350 for a non-blind individual and $2,260 for a blind individual. In other words, if you work and earn more than $1,350 per month, and you are not blind, you are not eligible for SSDI benefits.
“Took care of me from day one. Knowledgeable in all areas they specialize in. Most importantly they treated me with the utmost respect. Affleck & Gordon moved me from a very difficult situation I couldn't get through on my own.”Douglas W.
Affleck & Gordon won my case!
“I filed for SSDI and had to appeal, so I hired Affleck & Gordon. The attorneys talked to me with the utmost respect and treated me like I was actually someone, not just a number.”R. Duff
I could not be more grateful to the team at Affleck & Gordon.
“I would like to thank Affleck & Gordon for representing me in my SSDI case. They are professional and caring and were always available when I had questions and concerns. Even during a pandemic, they got the job done for me.”T. Curtis
Many SSDI claims are denied. This happens for a variety of reasons, from application errors to issues with medical conditions failing to meet the Social Security Administration’s definition of “disability,” problems with work credits, and more.
If your SSDI claim is denied, you have the right to appeal this decision.
Appealing a denied SSDI claim involves several steps:
- Reconsideration: The first step in appealing a denied SSDI claim is requesting a reconsideration. You may request a reconsideration for either a medical determination or a non-medical determination. If your original claim was denied for medical reasons (for example, if the Social Security Administration (SSA) claims that your medical condition does not meet its strict definition of “disability”), you may request a reconsideration for a medical determination. All other denial reasons require a request for reconsideration for a non-medical determination.
- Administrative Hearing: If you disagree with the SSA’s decision on your reconsideration, you may request a hearing before an administrative law judge (ALJ). Once you have requested an administrative hearing, you will receive a notice from the SSA informing you of the time and date of your hearing. These hearings often proceed much like a standard trial; you and your legal counsel may submit evidence in support of your claim, and the SSA may also submit evidence against your claim. The ALJ will issue a written decision based on the evidence at the conclusion of the hearing.
- Appeals Council Review: If you believe the ALJ made an error, or if you disagree with the outcome of the administrative hearing, you may request a review by the Social Security Appeals Council. The Appeals Council may grant or deny your request for a review. If it grants your request, it may return your case to the ALJ for further review, or it may issue a new decision on your case. However, the Appeals Council generally only grants requests for review when it determines that a legal or administrative error was made. If the ALJ’s decision was made according to applicable laws, your request for an Appeals Council review may be denied.
- Federal Court Review: The final step in appealing a denied SSDI claim is requesting a review by the federal court. You may request a federal court review if you disagree with the Appeals Council’s decision following its review of your case, or if you believe that an error was made. Your attorney can assist you in requesting and preparing for a federal court review.
At Affleck & Gordon, we care deeply about helping our clients obtain the disability benefits they need to manage everyday expenses and maintain their quality of life. We know how stressful it is to suffer a disability or be diagnosed with a serious medical condition, which is why we work tirelessly to help our clients face—and overcome—their physical, emotional, and financial challenges. As your legal team, we will be there for you every step of the way, offering personalized counsel and professional guidance based on decades of legal experience.
Our firm can assist you with all aspects of your SSDI case, including but not limited to:
- Determining whether you are eligible for SSDI
- Explaining the types of SSDI benefits you may be entitled to receive
- Gathering applicable documents and information to support your claim
- Filing your original SSDI claim with the Social Security Administration (SSA)
- Requesting a reconsideration or administrative hearing if your claim is denied
- Preparing for and navigating the SSDI appeals process
We are happy to answer your questions and address your concerns throughout the process. Our SSDI attorneys have extensive experience helping disabled individuals, veterans, and families throughout Georgia, and we look forward to serving you, too.